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Some Important MCQ > ENT And Opthalmology > Flashcards

ENT And Opthalmology Flashcards

1
Q

Rinne’s test positive and webers lateralizes to right. Meaning?

A

Rinne’s test positive : AC >BC
Weber’s lateralize to right: better hearing in right.
Therefore : sensorineural hearing loss in left ear

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2
Q

If rinne’s postive and weber latrralizes fo right. What test to do next?

A

Schwabach test
Compare patient’s hearing to examiner hearing.
If hearing is normal= test normal
If hearing low= test prolonged.

This helps to confirm sensorineural hearing loss.

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3
Q

Sago grain appearance seen in …..

A

Healed myringitis bullosa

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4
Q

Define myrinitis bullosa

A

Otitis externa hemorrhagica
Where blisters develop on tympanic membrane. When healed, forms small round bumps that resembles sago grain.

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5
Q

Cause of bullous myringitis (5)

A
  1. Strept pneumoniae
  2. H.Influenza
  3. Beta hemolytic streptococci
  4. Moraxella catarhalis
    5: Respiratory virus:
    rhinovirus,influenza A,parainfluenza virus,RSV, enterovirus.
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6
Q

Dx of bullous myringitis
Sms

A

Clinical
Sms: sudden onset severe one sided ear pain + URTI.
Conductive deafness and discharge of affected ear.

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7
Q

Define cholesteatoma. Where is it found ?
Cholesteatoma arise from …..
Associated with …..

A

Keratinizing squamous epithelial growth in middle ear or mastoid process.
Found in attic region aka epitympanum/upper part of middle ear.

Pars flaccida or superior part of TM

Retraction pockets or perforation in pars tensa- central thicker portion of TM

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8
Q

Antral Holler Miller sign seen in …..
There is anterior bowing of …..

A

Juvenile nasopharyngeal fibroma

Anterior bowing of maxillary antrum

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9
Q

What is glomus tumor ?

What is septal hematoma?

A

Arise from glomus body-nail of finger or toes.

Accumulation of blood within nasal septum due to trauma of nose.

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10
Q

Complication of septal hematoma
Rx

A

Septal perforation and infection
Surgical drainage of blood.

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11
Q

Approach to managing nasal bone fractures?

A
  1. Without septal involvement:
    Lower the edema—> closed reduction after 7 days
  2. Septal deviation:
    Septo- rhinoplasty
  3. Septal deviation with multiple fragments: open reduction
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12
Q
  1. Mc cause of epistaxis in elderly:
  2. Mgt in active bleeding :
A
  1. HTN
  2. a. Anterior /posterior packing
    b. Not controlled: arterial ligation
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13
Q
  1. Mx cause of epistaxis in children and adults
  2. Mx site of epistaxis
  3. Mc cause of epistaxis in 15 yr female
A
  1. Finger nail trauma
  2. Little’s area
  3. Hematopoetic d/o
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14
Q

U/l purulent nasal d/c with occasional blood is …..

A

Foreign body

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15
Q

Antrochoanal polyp seen in ….
Sms

A

Children and young adults
1. Benign polypoid lesion with nasal obstruction and nasal drainage
2. Always unilateral

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16
Q

Most common sms. of foreign body in children (3)

A
  1. Nasal obstruction
  2. Rhinorrhoea
  3. Post nasal drainage
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17
Q

Chronic granulomatous disease presenting with rhinorrhoea , epistaxis and nasal obstruction in third or fourth decade of life

A

Rhinosporidiosis

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18
Q

Antrochoanal polyp distribution

A

Arise from maxillary sinus( Antrum)
Extend through maxillary sinus ostium into nasal cavity into the choana( opening at back of nasal cavity).

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19
Q

Parotid duct is also known as …..
It is ….
Function

A

Stenson’s duct.
Major duct of parotid gland.
Drains saliva from parotid into oral cavity

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20
Q

If pus is present in parotid duct, it indicates ….

A

Infection of stensons duct-infection of parotid gland.

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21
Q

Describe trotter’s triad
Associated with ….

A

Hearing loss u/l
Facial pain
Palatal palsy

Malignant tumors of lateral wall of nasopharynx

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22
Q

Define Gradenigo syndrome

A

Triad:
otitis media, facial pain,abducens palsy

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23
Q

Samter’s triad aka…..
Characteristics (3)

A

Aspirin associated respiratory disease
Asthma
Recurrent nasal polyp
Sinus congestion

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24
Q

Features of adenoid facies (5)

A
  1. Open mouth
  2. High arched palate
  3. Protrusion of upper incisors
  4. Enlongation of facial structure
  5. Flattened mid face

—-Dennis Morgan lines, allergic shiner,nasal crease

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25
Q

Structures in the eye derieved from neural crest cells (4)

A
  1. Uveal melanocytes
  2. Trabecular mesh work
  3. Ciliary muscle
  4. Cornea
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26
Q

What is hyaloid artery?

A

Transient embryonic blood vessel that nourishes the developing lens during early stages of eye development.
As eye matures; it regress and remain as hyaloid canal or cloquet canal

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27
Q

Features of direct opthalmoscopy

A

Direct opthalmoscopy:
1. Condensing lens: not required

  1. Examination distance:
    as close to patient’s eye as possible
  2. Image: virtual, erect
  3. Magnification: 15 times
  4. Illumination: not bright,not useful in hazy media
  5. Area of field in focus: 2D
  6. Stereopsis: absent
  7. Accessible fundus view:
    Slightly Beyond the equator
  8. Examination through hazy media:
    Not possible
  9. Patient sitting position:
    Easy, sitting position , can visualize posterior pole of retina.
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28
Q

Features of indirect Opthalmoscopy (10)

A
  1. Condensed lens: convex lens
  2. Examination distance: at arms length
  3. Image: real inverted
  4. Magnification: 4-5 times
  5. Illumination:
    bright,useful for hazy media
  6. Area of field in focus : 8D
  7. Stereopsis: present
  8. Accessible fundus view:
    Upto orra serrata-peripheral pole of retina
  9. Exam through hazy media: possible
  10. Patient position ease:
    Supine, difficult, require training.
29
Q

Trauma to the eye with vegetable matter can cause…..

A

Fungal ulcer

30
Q

Clinical features of mycotic corneal ulcer:

A

Red FISH
Rolled out dry elevated margins
Feathery finger like projections
Immune ring
Satellite lesions
Hypopyon

31
Q

Define geographical ulcer
Associated with ….(2)

A

Non infectious
Irregular borders and epithelial defects

Associated with
Neurotrophic keratitis
Exposure keratopathy

32
Q

Feature of acanthameoba keratitis (3)

A

Severe Pain
Photophobia
Corneal ring infiltrates aka radial keratoneuritis

33
Q

Chronic irritation of both eyes in young female with papillary conjunctivitis and corneal filaments s/o…

Most important test to consider is…

A

Autoimmune conditions / dry eye syndrome

Thyroid function test- Graves’ disease
Schirmer test

34
Q

Signs of heterochromic iridocyclitis of Fuch(6)
Most important sign seen…..

A
  1. Gradual blurring of vision in one eye
  2. Diffuse iris atrophy
  3. Small white stellate keratic ppt (deposits in inner surface of cornea)
  4. Cells in anterior chamber and anterior vitreous.
  5. Acqueous flare
  6. posterior subcapsular cataract and glaucoma

Most important sign: amsler sign- when cut anterior chamber, there is hyphema in anterior chamber due to bv present.

35
Q

Intermediate uveitis is also known as ….
Define

A

Pars planitis
I.f of middle layer of eye -lens, ciliary body

36
Q

Sms of intermediate uveitis (7)

A
  1. Blurred vision
  2. Dark floaters in vision field interfering with vision
  3. Swelling inside the eye
  4. Glaucoma
  5. Vision loss.
  6. Cataract-as d/s progress
  7. Retinal detachment-as d/s progress
37
Q

What is heerfordt’s disease?
Sms (5)

A

Variant of sarcoidosis
1. Parotid gland enlargement
2. Generalized fever
3. facial nerve palsy
4. Anterior uveitis
5. Ocular involvement

38
Q

Sms of subacute iridocyclitis (5)

A

Painful red eye - around iris
Blurred vision
Miosis
Headaches
Photophobia

39
Q

Painful red eye, florid rubiosis s/o
Rx

A

Central retinal vein occlusion
Panretinal photocoagulation

40
Q

Describe pan retinal photocoagulation

A

Laser used to burn certain areas of retina, decrease oxygen demand to that area—> decrease in neovascularization.
Also used in DR

41
Q

What is seton implantation

A

Glaucoma resistant to surgery
Place a drainage tube to control IOP

42
Q

What is diode photocoagulation?

A

Laser to target and reduce size of ciliary body which produces acqueous humor to decrease IOP.
Used in refractory glaucoma

43
Q

What is laser iridotomy?

A

Laser to create a hole in the iris, to make acqueous humor flow from posterior to anterior chamber to relieve pupillary block.

Used in angle closure glaucoma

44
Q

Describe pigmentary retinal dystrophy
Sms?

A

Inherited retinal disorders characterized by degeneration of photoreceptor cells in the retina.
Early sms: night blindness,tunnel vision

45
Q

Fundoscopic changes in RP?
Perimetry s/o

A
  1. Attenuation of arterioles
  2. Waxy pallor of optic disc
  3. Bone-spicule like pigmentation in mid- peripheral retina

Perimetry: ring scotomas

46
Q

Define Staghart’s disease
Signs
It has ……inheritance pattern

A

Inherited retinal dystrophy that leads to degeneration of macula—-> loss of central vision.

B/l symmetric macular atrophy
Yellow-white flecks in the macula -made of lipofuscin pigments in retinal pigment epithelium.

Autosomal recessive

47
Q

Define Best’s disease

A

Accumulation of lipofusin leading to egg yolk appearance on Fundoscopy.
There is central vision loss and abnormal EOG finding

48
Q

Expand ERG ,EOG

A

Electroretinogram
Electrooculogram

49
Q

Vision loss in retinitis pigmentosa

A

Peripheral vision loss—> eventual central vision loss

50
Q

Central vision loss—> peripheral vision loss

A

Cone-rod dystrophy

51
Q

Define Coat’s disease (4)

A
  1. Affects u/l eyes of young males
  2. Abnormal development of blood vessels in the retina—> retinal ischemia
  3. Disease is due to aneurysm and telangiectasic vessels
  4. There is subretinal yellow exudates
52
Q

Colobamas present mainly in…..

A

Upper eyelid- but can also be in upper and lower eyelid

53
Q

Coloboma in medial upper eyelid is ….
Lower eyelid Rx

A

Isolated finding
Congenital abnormalities -cleft lip/palate
Rx: surgical correction, also eyelid must be lubricated well to prevent dryness of cornea and conjunctiva.

54
Q

Define cryptophthalmos
Define ankylobhlepharon

A

Failure of eyelid to develop and separate
Ass with malformed eye

Fusion of all or parts of eyelid

55
Q

What is distichiasis ?
Trichiasis?

A

Extra row of eyelashes arising from normal posterior row of eyelashes

Misdirected eyelashes

56
Q

Define Artl’s line

A

Entropion of upper and lower eyelid + linear conjunctival scars -upon eversion of upper eyelid.
Due to chronic condition affecting the conjunctiva.

57
Q

Artl’s line seen in …….
Features of trachoma (3)

A

Trachoma-stage 3/cicatricial stage

Follicles
Scarring
Cicatricial entropion.

58
Q

Pseudomembranes of conjuctiva s/o

A

Ligneous conjunctivitis

59
Q

Define parinaud’s oculogranular syndrome? (2)

A

Granulomatous conjuctivitis
Periauricular LAP
—in response to infection/neoplasm

60
Q

Features of kawasaki disease (7)

A
  1. Acute febrile illness lasting 5days
  2. B/l non exudative conjunctivitis
  3. Mucosal membrane changes including redness and cracking of lip
  4. Strawberry tongue
  5. Skin rash- peeling of skin
  6. Swelling of hands and feet
  7. Cervical LAP
61
Q

Features of HSP

A

Rash, joint pain,GI sms, renal sms

62
Q

Congenital stationary night blindness is …

A

Oguchi disease

63
Q

Difference between CRAO and CRVO

A

CRAO:
sudden painless LOV,
optic disc pallor,Cherry red spots, segmental loss of bv->boxcarring effect

CRVO:
painless u/l LOV,
retinal hges,
cotton wool spots,
dilated tortorous veins

64
Q

Facial nerve functions (4)
Facial nerve exits via….

A
  1. Fibers to orbicularis oculi of facial muscle( facial expression )
  2. Small area of ear
  3. Parasympathetic nerves to submandibular and sublingual gland via chorda tympani.
  4. Lacrimal gland via greater petrosal nerve

Exits the brainstem via cerebellopontine angle

65
Q

Wolfram syndrome aka…..

A

DIDMOAD
Diabetes insipidus
Diabetes Mellitus
Optic atrophy
Deafness

66
Q

Wolfram syndrome presents in …..
Other features (3)

A

Childhood or adolescence
1. Neurological abnormalities
2. Urinary tract problems
3. Psychiatric disturbances

67
Q

What is kjer syndrome?
What is behr syndrome? (4)

A

Hereditary b/l optic atrophy

  1. Progressive Spastic paresis(weakness and spasticity of legs )
  2. Optic atrophy
  3. Ataxia
  4. Mental retardation
68
Q

Difference between botulinum toxin eye problem and tensilon test

A

Botulinum toxin: ptosis, opthalmoplegia, fixed dilated pupils

Tensilon test: ptosis,,opthalmoplegia, normal pupils.

69
Q

GQI antibody is done for …..

A

Miller Fischer syndrome
Variant of GBS
Opthalmoplegia,ataxia,areflexia,pupil problems

Some Important MCQ (1 decks)

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